Autism
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Autism starts when a child is very young. Children with autism have:
- language that develops slowly or not at all
- a lack of interest in social play, making eye contact, smiling, or cuddling
- certain behaviors that are repeated or intense reactions to changes in routine
Children with autism may also have very strong reactions to certain things they touch, taste, or hear. They may get upset easily or have a lot of tantrums.
The Need for Help
Today, we know that autism is more prevalent than we once thought. In Iowa alone, there are thousands of children diagnosed with autism. Coordinating care between several specialists can be a complicated and overwhelming process, especially for families dealing with a new diagnosis. University of Iowa Stead Family Children’s Hospital Center for Disabilities and Development is here to make that process easier.
Diagnosis and screening of Autism
Autism is a neurodevelopmental disorder characterized by significant impairments in the areas of communication, social interaction, and atypical behaviors.
Autism is four times more common in males than females and can be associated with intellectual impairment and co-occurring medical diagnoses including seizure disorders, anxiety, depression, and attention deficits.
Prevalence rates for autism have risen substantially over the past two decades, with a recent epidemiological survey identifying a national rate of 1 in 36 children. Based upon this prevalence rate, it is estimated that approximately 2.7% of Iowa’s children have autism.
Much of the increase in autism appears to be the result of both improved detection and a broadening of the diagnostic criteria, although other factors that may play a role are currently being explored.
Autism is a highly heritable disorder, and multiple candidate genes have been implicated.
Lifetime costs associated with management have been estimated to exceed $3 million per person with autism.
Diagnosis of Autism
Autism is defined by qualitative impairments in social communication, and restricted repetitive interests and activities. Common symptoms include poor eye contact, poor “reading” of social cues, failure to develop peer relationships, lack of social or emotional reciprocity, delayed speech, difficulty sustaining conversation, lack of make-believe play, repetitive motor mannerisms, and rigid adherence to routines.
Importance of early identification
Although there is no cure for autism, interventions have been identified that can successfully improve functioning for many persons with this diagnosis. The most positive outcomes have been shown to occur when intervention is delivered intensively to young children. The importance of early identification in improving outcomes has resulted in an emphasis on training healthcare providers to accurately identify young children at risk for autism. In 2007, the American Academy of Pediatrics recommended that pediatricians conduct universal screenings using an autism-specific screening instrument at 18- to 24-month appointments.
In most cases, autism can be reliably diagnosed as early as 18 months of age. An accurate diagnosis is based on observation of the child’s communication, social interaction, behavior, and developmental level. Early signs that a child may have autism include:
- Little or no eye contact
- Poor response to name
- Lack of or delay in spoken language
- Failure to respond to or initiate joint attention
- Failure to imitate caregivers
- Lack of interest in other children
- Lack of spontaneous or make-believe play
- Persistent fixation on parts of objects
- Unusual motor mannerisms (e.g., hand-flapping, lining up objects)
Referral for a formal evaluation of autism may be warranted if a parent reports that their child exhibits one or more of these behavioral indicators.
Several measures have been developed to assist in the screening of autism in young children. A common measure is the Modified Checklist for Autism in Toddlers, Revised (M-CHAT-R). This 23-item screener is for toddlers between the ages of 16 to 30 months. It usually takes around five minutes for caregivers to complete the M-CHAT and two minutes for a healthcare professional to score the measure. The M-CHAT is free and currently available in 30 languages. Parents and guardians who are concerned their young child might have autism can complete a free version of the M-CHAT-R here. The site will provide a free score that families can share with their doctor.
If a young child does not pass an autism screening, a formal evaluation for autism may be warranted. This evaluation should include a developmental history, developmental assessment, and direct observations of the child’s communication and social behavior. If a local evaluation for autism is not available, families can reach out to the Autism Center at the UI Stead Family Children’s Hospital Center for Disabilities and Development to request an evaluation with our team of specialists.
Services
We offer the following clinical services at Center for Disabilities and Development:
- Team evaluations for diagnosis: Determining whether your child has autism and providing treatment recommendations
- Medication management: Recommending and adjusting medications used by children with autism
- Behavior assessment: Identifying challenging behaviors, including feeding problems, and finding ways to help
- Early intervention: Teaching play and communication skills to young children with autism
- Evaluating academic and learning problems, including intellectual disability
- Evaluating speech and language, feeding, and sleep disorders
- Evaluating daily living skills, such as eating, dressing, and walking
- Evaluating assistive technology needs
- Evaluation and support for teenagers transitioning to adulthood
We work hard to make your visit convenient and efficient, and we communicate with your family doctor or other health care providers to make sure everyone understands the care your child needs.
To request an appointment for any one of these services, please call 855-842-8847.
Resources and Community Support
We connect families to resources and support in their communities, including respite care and child care, safety equipment, support groups, vocational programs, self-advocacy support, and more.
Here are some local resources we like:
- Disability Resource Library
- Safety Store
- Autism Society
- Iowa Compass
- Iowa Regional Autism Assistance Program (RAP)
Here are some national resources we like:
- Autism Speaks
- National Autism Center
- Center for Disease Control and Prevention
- Autism Internet Modules
- American Academy of Pediatrics
Education and Training
We provide autism education and training to parents, teachers, students, and doctors through seminars and conferences. We focus on early identification, help for challenging behaviors, and proven methods for treating autism.
Research
We are actively researching the causes of autism, as well as new and better treatments. Genetic testing, behavior therapy, and the use of telehealth services for families in other communities are just a few of the areas we are exploring to provide the latest and best care for those with autism.
Autism Research Opportunities
Simons Foundation Powering Autism Research (SPARK) aims to help scientists find and better understand the potential causes of autism. As part of this effort, we study DNA from people with autism and from their family members who may or may not have autism. We also study information about their health and things that can impact health like behavior and lifestyle. To succeed, SPARK needs many thousands of people with autism and their families to join. What we collect and learn will be shared with many autism researchers to help speed up the progress of autism research.
Our Care Team
- Center for Disabilities and Development
- Psychiatry
- Psychology
- Center for Disabilities and Development
- Psychiatry
- Psychology
- Center for Disabilities and Development
- Center for Disabilities and Development
- Center for Disabilities and Development
- Center for Disabilities and Development
- Center for Disabilities and Development
- Center for Disabilities and Development
- Department of Pediatrics
- Center for Disabilities and Development
- Department of Pediatrics
- Center for Disabilities and Development
- Center for Disabilities and Development
- Center for Disabilities and Development
Ali McCue, MA, CCC-SLP